Amgen announced positive results from the Phase 3b LIBERTY study assessing the efficacy and safety of Aimovig (erenumab) 140 mg in patients with episodic migraine who had experienced two to four previous preventive treatment failures, due to lack of efficacy or intolerable side effects. The study met its primary endpoint, with significantly more patients taking Aimovig experiencing at least a 50 percent reduction from baseline in their monthly migraine days as compared to placebo. LIBERTY also met all secondary endpoints, including reduction of monthly migraine days, reduction in days needing acute (rescue) medication, improvement in scores on the Migraine Physical Function Impact Diary (MPFID) tool, and 75 percent and 100 percent responder rates (number of patients experiencing at least a 75 percent or 100 percent reduction in monthly migraine days compared to placebo). The safety data are consistent with previous studies of Aimovig to date. Full data will be presented at an upcoming scientific meeting.
Aimovig is the only investigational fully human monoclonal antibody, designed to selectively block the calcitonin gene-related peptide (CGRP) receptor, which plays a critical role in migraine activation. These results are the first positive placebo-controlled data ever reported in an episodic patient population consisting entirely of those who have tried and failed two to four preventive medications due to lack of efficacy or intolerable side effects.
"We've purposely designed a clinical program for Aimovig that examined a broad spectrum of migraine patients, ranging from those who have never tried a preventive treatment to patients who have tried and failed such treatments," said Sean E. Harper, M.D., executive vice president of Research and Development at Amgen. "These data in patients with multiple treatment failures, who are not only considered difficult to treat but also have few options available, add to the consistent body of evidence for Aimovig. We look forward to working with regulators to bring the first preventive option specifically developed for migraine to patients worldwide."
The safety, efficacy and tolerability of Aimovig have been assessed in more than 3,000 patients, including an ongoing open-label extension of up to five years in duration. Aimovig was the first investigational therapy targeting the CGRP pathway to receive U.S. Food and Drug Administration (FDA) and European Medicines Agency regulatory filing acceptance. The FDA has set a Prescription Drug User Fee Act (PDUFA) target action date of May 17, 2018. If approved, it will be administered once-monthly using a self-injection device. If approved, Novartis and Amgen will co-commercialize Aimovig in the U.S. Amgen has exclusive commercialization rights to the drug in Japan and Novartis has exclusive rights to commercialize in rest of world.
LIBERTY (NCT03096834) is a Phase 3b, multicenter, randomized 12-week, double-blind, placebo-controlled study evaluating the safety and efficacy of Aimovig in patients with episodic migraine (defined in the trial as four to 14 migraine days per month at baseline) who have failed up to four prior preventive treatments for migraine. In the study, 246 participants with episodic migraine who had two to four previous treatment failures were randomized to receive Aimovig 140 mg or placebo during the 12-week double-blind treatment phase. The primary endpoint was the percentage of patients with at least a 50 percent reduction of monthly migraine days from baseline over the last four weeks of the double-blind treatment phase of the study (weeks 9-12). The study includes an ongoing 52-week open-label extension study.
Secondary endpoints assessed during the same time period included: change from baseline in monthly migraine days, change from baseline in the number of monthly acute migraine-specific medication treatment days, and change from baseline in the MPFID physical impairment and impact on everyday activities domain scores. The MPFID is a scale developed to measure these two domains. The scale has been validated in line with FDA Patient Reported Outcomes Guidance. Percentages of patients with a 75 percent response rate and 100 percent response rate to erenumab were also assessed as secondary endpoints.
Aimovig is the only treatment specifically designed to prevent migraine by blocking the CGRP receptor, which is associated with migraine activation. Aimovig has been studied in several large global, randomized, double-blind, placebo-controlled studies to assess its safety and efficacy in migraine prevention. The safety, efficacy and tolerability of Aimovig has been assessed in more than 3,000 patients, including an ongoing open-label extension of up to five years in duration. Regulatory submissions have been filed in the U.S. and Europe.
People with frequent migraine may lose more than half their life to migraine days. Migraine robs individuals of time with their families, productivity at home and at work, and their livelihoods. Migraine sufferers endure debilitating pain, physical impairment, and live in constant dread of the next attack – all of which is compounded by a widespread misperception of the disease. The World Health Organization ranks migraine as one of the most debilitating illnesses. For the approximately 10 million Americans whose migraine frequency or severity impacts daily activities, preventive medications may be an option. Approximately 3.5 million of these patients are currently on a preventive therapy, but up to 80 percent discontinue these within one year. Migraine is associated with personal and societal burdens of pain, disability, and financial cost, and it remains under-recognized and under-treated.